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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �`�f �� <br />3200 CEC,4R STREET, EVERETT, WA 96201 <br />425-257-8810 - FAX425-257-8857-www.everettwa.org G/Gn7-OdC! <br />APPLICATIONS ARE ACCEPTED FROM 0 AM TO 4 PM <br />�� � �1'� u c��c�' <br />PROJECT ADDRESS <br />.�G1�! l �J <br />Owner <br />Tenant <br />Eleclrical Conlrector <br />Mail Address <br />Mail �`ddress <br />Mail Address <br />��S �,5� � oG w, . <br />Stato License Number <br />Proposed Use of Building <br />� n��l `� I� - St, <br />City <br />City <br />°} D� St Sh, <br />ary <br />�- 3�-F`i'-�'�-k"b8 <br />Stale/Zip <br />Stale/Zip <br />�J1( `1�1L <br />Phone <br />Phono <br />Slatc/Zip Phone <br />/-f �-S �ko3 9-�-�� <br />�Q,nc� <br />Conlract Price of Work <br />Contact Person (Plan Reviow) <br />Doscriplion of Work lo �o Done: � r,� r� (,J i�'' C y+"1 4 �C.,c� <br />��\ �r a f I =fS <br />NOTL": WIRING IN NON-DWELLINGS IS REQUIREn rJ <br />BE IN RACEWAYS, MC OR AC CABL6. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I heiehy ccrti/y f/mt I Im��e read and <br />cormcf. All pruvisions olla�vs and c <br />ivhe;herspecdiedhe�einornat. Thi <br />violafe or cancel the pr'ovisiuns ol a� <br />pe!fo�manr,eo/consl�uction. Thall <br />wark Ior which application is mnde a <br />296200 WAC. \ <br />''." � <br />1-" <br />� - i /', <br />P' <br />Signature �� <br />^z�arrtined this applicaf <br />efinances govemmg ff <br />yranfin� �i/a pennd d <br />�� ofher stafe or local H <br />am aufhaized by (he c <br />�td I compl}� n�ilh fhe Si <br />1� <br />� <br />� <br />ar�d know the same fo bu frue and <br />✓po of work �rill Go completed <br />not �r�;sume fo give authonty fo <br />�egul.3ting consWction orthe <br />�r ol this property lo perlonn fhe <br />Cenfrac(ors Law 7827 RCIN and <br />-/C! <br />FEE <br />;'_ lCY7=�_ ��� <br />